Gastroenterologist Jaya Agrawal: the importance of a colonoscopy

Submitted photoGastroenterologist Jaya Agrawal will present an informational program about colon cancer at the Northampton Senior Center, 67 Conz St., on March 29 from 1:30 to 2:30 p.m. that is free to the public.

Dr. Jaya Agrawal is a board-certified gastroenterologist on the medical staff of Cooley Dickinson Hospital in Northampton.

Agrawal, who is in practice at Hampshire Gastroenterology Associates in the Florence section of Northampton, She will present an informational program about colon cancer at the Northampton Senior Center, 67 Conz St., on March 29 from 1:30 to 2:30 p.m.

This program is free to the public and registration can by done by calling (413) 587-1228.

The following is a submitted interview with Agrawal about the importance of having a screening colonscopy.

According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. In 2012, the society estimates that 103,170 new cases of colon cancer and 40,290 new cases of rectal cancer will be diagnosed.

Overall, the lifetime risk of developing colorectal cancer is about 1 in 20 (5.1 percent). This risk is slightly lower in women than in men. Colorectal cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately, and the second leading cause when both sexes are combined.

It is expected to cause about 51,690 deaths during 2012. This problem is not just national, it is local. Estimates from the Massachusetts Department of Public Health, show that colorectal cancer is the third leading cause of cancer death in Massachusetts.

But there is also good news: the death rate from colorectal cancer has been dropping for more than 20 years. One reason is that polyps are being found by screening colonoscopy and removed before they can develop into cancers.

Screening also identifies cancer at an earlier stage when the disease is easier to cure. In addition, treatment for colorectal cancer has improved over the last several years. As a result, there are now more than one million survivors of colorectal cancer in the United States.

Here are some answers to questions I often get asked.

Q: I am 50 years old. My bowels move perfectly well. I have no bleeding or any other symptoms. Do I need to be screened for colon cancer?

A: Yes. In the early stages of the disease, when it is most treatable, colorectal cancer often has no symptoms at all. Precancerous polyps are found in 15 percent of women and 25 percent of men at the time of screening and most often cause no symptoms.

Q: If I have healthy habits, a healthy diet and no family history of cancer or polyps, am I protected from colon cancer?

A: Absolutely not. Healthy, non-smoking, non-drinking, normal weight vegetarians can still get colon cancer. Most people we diagnose with colon cancer have no significant family history. If you fall under this category and you have no symptoms, your primary care doctor will likely determine that you are “average risk” for colon cancer and recommend screening at age 50.
Q: Is there any reason to be evaluated for colon cancer before the age of 50?

A: While overall, colon cancer rates are decreasing in the older, screening-eligible age groups, the incidence in some of the younger age groups is increasing for unexplained reasons. Reasons to discuss colorectal cancer evaluation with your primary care doctor before the age of 50 are reviewed below.

Family history of colon cancer, polyps, or genetic cancer syndrome

Personal history of inflammatory bowel disease, polyps, polyposis syndrome, genetic cancer syndrome or history of other cancers

Symptoms that should be discussed with your doctor:

Blood in the stool

Microscopic blood in the stool

Unexplained low blood counts

Unexplained weight loss

Change in bowel habits

Call or see your primary care physician to determine if you should be screened or evaluated for colon or rectal cancer; and if so, which test is most appropriate for you.

If you are determined eligible or appropriate for a colonoscopy you may be referred directly for the procedure or they may schedule you to be seen by a gastroenterologist in the office for a longer discussion of the procedure, preparation, sedation, risks and benefits based on your personal health and family history.